What is the scope of maternity nursing Caring for patient, baby, partner and family pre-pregnancy through postpartum.
What are landmark years and changes within Maternity Nursing? 1920s: spike in mortality led to origin of maternity nursing in trying to discover how to lower rates 1940s: extended ...
NURS 334 Final Exam Questions and
Correct Answers
What is the scope of maternity nursing ✅Caring for patient, baby, partner and family
pre-pregnancy through postpartum.
What are landmark years and changes within Maternity Nursing? ✅1920s: spike in
mortality led to origin of maternity nursing in trying to discover how to lower rates
1940s: extended care to include family during pregnancy process
1969: Association of Women's Health, Obstretical, and Neonatal nurses was born
(governing)
Today: has subspecialties in maternity nursing
How has Maternity Nursing changed over the years? ✅Changed from looking at
pregnancy as solely a medical procedure to more patient driven and viewing pregnancy
and birth as healthcare provdiers being partners in care
Ethnocentrism ✅is the negative end viewing one's own culture as the best for
everyone
Cultural relativism ✅is the positive end where you view your own culture as what is
best for you but value that another persons culture is what is best for them. This value
comes in the form of learning about and applying others cultures
Cultural competence ✅is having knowledge about patients culture so that you can act
in a way that meets clients' needs
hCG ✅initial hormone to maintain pregnancy
-prevents involution of corpus luteum.
-Corpus luteum increases production of estrogen & progesterone until the 11th week,
when the placenta takes over.
-Maximum level at 50-70 days & then begins to decrease.
-After progetersone and estrogen take over so hCG is no longer necessary
-Detectable in maternal blood as soon as implantation occurs, usually 8-10 days after
fertilization.
-Basis for pregnancy tests.
hCS ✅adjusts metabolism
-Stimulates adjustments in metabolism, so that adequate protein, glucose, & minerals
are available for developing fetus.
-Increases resistance to insulin, facilitates glucose transport across placental
membrane, & stimulates breast development.
,progesterone ✅relaxation
-Responsible for body tissues to "relax" or decrease tone.
-Vascular: relax blood vessel walls (causes hemorrhoids and edema)
-GI: constipation, heartburn and gall bladder disease
-Respiratory: decrease airway resistance
-Renal: urinary stasis, bladder infections and UTIs
estrogen ✅proliferation
-Builds Tissue: Either increases the size or # of tissues, blood vessels, & blood cells.
-increase size of uterus, external genitalia, breast, blood, lymphatic, nerve supply to
uterus
-increased fat tissue, WBCs, fibrinogen, clots
-softening connective and collagen tissue
-retain more sodium and water
Heart size change in pregnancy ✅slight cardiac enlargement
Blood volume change in pregnancy ✅increased by 40-45% (7.5 L)
HR change in pregnancy ✅-Between 14 & 20 weeks heart rate increases
approximately 10-15 beats/min.
-Palpitations may occur due to increases in thoracic pressure.
-Recognize this is completely normal
Peripheral vascular resistance change in pregnancy ✅-decreased
-These changes allow body to accommodate increased blood volume without pressure
changes
-Orthostatic hypotension is common because vascular dilation happens faster than
increase in blood volume
lab values changes in pregnancy ✅decreased hematocrit
leukocyte are normal or slightly higher
increased coagulation (risk for DVT)
how wold you explain pregnancy changes to your patient? ✅
vena caval syndrome ✅-Dizzy, clammy, and pale.
-Caused by weight of uterus resting heavily on vena cava when pregnant person is lying
flat on their back.
-worse laying on back
vena caval syndrome intervention ✅Rapid relief occurs by having pregnant person turn
onto their side or by raising head of bed.
, pregnancy respiratory changes ✅-Maternal oxygen requirements increase during
pregnancy
-Decrease in airway resistance
-Increased tidal volume (essentially how much the lungs can hold) (how much is
availabel for gas exchange), more efficiently ventilating
-Decreased blood PCO2
-Increased tidal volume
pregnancy metabolic changes ✅-Cells become insulin resistant
-Increase in glycogenesis - stored glucose as fat
-Expected weight gain dependent on pre-pregnancy BMI and number of fetuses
-Expect person to be tired because not metabolizing glucose
-Body stores fat in order to have glucose more readily available for milk production
pregnancy integumentary changes ✅-Sweat & sebaceous glands of skin become more
active
-Palms of hands may become deeper red
-PUPPP
-Abdominal striae aka stretch marks
-linea nigra: line goes up abdomen
-Chloasma gravidarum
Pruritic urticarial papules & plaques of pregnancy (PUPPP) ✅-Almost like an allerigc
reaction to pregnancy
-Rash can give hydrocortisone to help with discomfort
-Does not hurt mom or baby but can be itchy and very uncomfortable
Chloasma gravidarum ✅-Looks like freckles and darkening of the skin, looks like
someone put on too dark of foundation
-Eyes, neck, ears and underneath the chin keep regular skin tone, just not the face itself
pregnancy GI changes ✅-Larger uterus displaces stomach & intestines toward back &
sides of abdomen
-Acidity of gastric secretions is decreased
-Emptying of stomach & motility of intestines is slower
-Causes nausea in the first trimester then constipation in the third
-Gums may become tender & bleed more easily
-Pyrosis (heartburn) frequent complaint due to relaxation of cardiac sphincter of
stomach, which permits reflux
Pregnancy: Musculoskeletal Changes ✅Tendons and ligaments relax allowing for
flexibility in the joints to support the growing uterus and prepare for birth
Birth control implant ✅•Implant placed under the skin of the upper arm
•99% effective
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